Yes

Antibiotic, Penicillin

Dental: Antibiotic for standard prophylactic regimen for dental patients who are at risk

Medical: Treatment of otitis media, sinusitis, and infections caused by susceptible organisms involving the respiratory tract, skin, and urinary tract; prophylaxis of bacterial endocarditis in patients undergoing surgical or dental procedures; approved in combination with clarithromycin and lansoprazole for eradication of H. pylori; in patients with active duodenal ulcer disease or a 1-year history of duodenal ulcer. The combined use of lansoprazole and amoxicillin is approved for patients unable to take clarithromycin.

B

Hypersensitivity to amoxicillin, penicillin, or any component

In patients with renal impairment, doses and/or frequency of administration should be modified in response to the degree of renal impairment; a high percentage of patients with infectious mononucleosis have developed rash during therapy with amoxicillin; a low incidence of cross-allergy with other beta-lactams and cephalosporins exists

1% to 10%:

Central nervous system: Fever

Dermatologic: Urticaria, rash

Miscellaneous: Allergic reactions (includes serum sickness, rash, angioedema, bronchospasm, hypotension, etc)

<1%: Seizures, anxiety, confusion, hallucinations, depression (with large doses or patients with renal dysfunction), nausea, vomiting, leukopenia, neutropenia, thrombocytopenia, jaundice, interstitial nephritis

Symptoms of penicillin overdose include neuromuscular hypersensitivity (agitation, hallucinations, asterixis, encephalopathy, confusion, and seizures) and electrolyte imbalance with potassium or sodium salts, especially in renal failure

Hemodialysis may be helpful to aid in the removal of the drug from the blood, otherwise most treatment is supportive or symptom directed

Decreased effect: Efficacy of oral contraceptives may be reduced

Increased effect: Disulfiram, probenecid may increase amoxicillin levels

Increased toxicity: Allopurinol theoretically has an additive potential for amoxicillin rash

Oral suspension remains stable for 7 days at room temperature or 14 days if refrigerated; unit dose antibiotic oral syringes are stable for 48 hours

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin binding proteins (PBPs); which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.

Absorption: Oral: Rapid and nearly complete; food does not interfere

Distribution: Widely distributed to most body fluids and bone; penetration into cells, eyes, and across normal meninges is poor

Protein binding: 17% to 20%

Ratio of CSF to blood: Normal meninges: <1%; Inflamed meninges: 8% to 90%

Metabolism: Partial

Half-life:

Neonates, full-term: 3.7 hours

Infants and Children: 1-2 hours

Adults with normal renal function: 0.7-1.4 hours

Patients with Cl_cr <10 mL/minute: 7-21 hours

Time to peak: 2 hours (capsule) and 1 hour (suspension)

Elimination: Renal excretion (80% as unchanged drug); lower in neonates

Oral:

Subacute bacterial endocarditis prophylaxis: 50 mg/kg 1 hour before procedure

Adults: 250-500 mg every 8 hours or 500-875 mg twice daily; maximum dose: 2-3 g/day

Endocarditis prophylaxis: 2 g 1 hour before procedure

Helicobacter pylori: 250-500 mg 3 times/day or 500-875 mg twice daily; clinically effective treatment regimens include triple therapy with amoxicillin or tetracycline, metronidazole, and bismuth subsalicylate; amoxicillin, metronidazole, and an H₂-receptor antagonist; amoxicillin, lansoprazole, and clarithromycin.

Dosing interval in renal impairment:

Cl_cr 10-50 mL/minute: Administer every 12 hours

Cl_cr <10 mL/minute: Administer every 24 hours

Dialysis: Moderately dialyzable (20% to 50%) by hemo- or peritoneal dialysis; approximately 50 mg of amoxicillin per liter of filtrate is removed by continuous arteriovenous or venovenous hemofiltration (CAVH); dose as per Cl_cr <10 mL/minute guidelines

Food: May be taken with food

With prolonged therapy, monitor renal, hepatic, and hematologic function periodically; assess patient at beginning and throughout therapy for infection; monitor for signs of anaphylaxis during first dose

May interfere with urinary glucose tests using cupric sulfate (Benedict's solution, Clinitest®); may inactivate aminoglycosides in vitro

Rarely large doses may produce confusion, hallucinations, and depression; penicillins have been reported to cause apprehension, illusions, agitation, insomnia, depersonalization, and encephalopathy

Disulfiram may increase amoxicillin levels

No information available to require special precautions

Prolonged use of penicillins may lead to development of oral candidiasis

Take entire prescription, even if you are feeling better. Take at equal intervals around-the-clock; may be taken with milk, juice, or food. You may experience nausea or vomiting (small frequent meals, frequent mouth care, sucking lozenges, or chewing gum may help). If diabetic, drug may cause false tests with Clinitest® urine glucose monitoring; use of glucose oxidase methods (Clinistix®) or serum glucose monitoring is preferable. This drug may interfere with oral contraceptives; an alternate form of birth control should be used. Report rash; unusual diarrhea; vaginal itching, burning, or pain; unresolved vomiting or constipation; fever or chills; unusual bruising or bleeding; or if condition being treated worsens or does not improve by the time prescription is completed.

Assess patient at beginning and throughout therapy for infection; observe for signs and symptoms of anaphylaxis; obtain specimens for C&S before the first dose; administer around-the-clock rather than 3 times/day, etc, (ie, 8-4-12, not 9-1-5) to promote less variation in peak and trough serum levels

With prolonged therapy, monitor renal, hepatic, and hematologic function periodically

Capsule, as trihydrate: 250 mg, 500 mg

Powder for oral suspension, as trihydrate: 125 mg/5 mL (5 mL, 80 mL, 100 mL, 150 mL, 200 mL); 250 mg/5 mL (5 mL, 80 mL, 100 mL, 150 mL, 200 mL)

Powder for oral suspension, drops, as trihydrate: 50 mg/mL (15 mL, 30 mL)

Suspension, oral: 200 mg/5 mL; 400 mg/5 mL

Tablet, chewable, as trihydrate: 125 mg, 200 mg, 250 mg, 400 mg

Tablet, film coated: 500 mg, 875 mg

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